Short Report: High Incidence of Shigellosis Among Peruvian Soldiers Deployed in the Amazon River Basin

Abstract

We investigated the etiology of acute diarrhea among Peruvian military recruits undergoing three months of basic combat training near the Amazonian city of Iquitos. From January through September 2002, 307 of 967 recruits were seen at the Health Post for diarrhea (attack rate [AR] = 31.8%, incidence = 1.28 95% confidence interval [CI] = 1.14-1.43] episodes/person-year). Shigella spp. were the most common bacterial pathogen recovered from recruits experiencing diarrhea episodes. These bacteria were isolated from 89 (40%) of 225 diarrheal stools examined (AR = 7.6%, incidence = 0.30 [95% CI = 0.24-0.38] episodes/person-year). Most (83 of 90; 92%) of the Shigella isolates were S. flexneri, of which 57 (69%) were serotype 2a. Seventy-six percent of Shigella isolates were resistant to sulfamethoxazole/trimethoprim and all were sensitive to ciprofloxacin. Peruvian soldiers may be an excellent population in which to test the efficacy of S. flexneri vaccines in advanced development.

Frequency of serovars and antimicrobial resistance in Shigella spp. from Brazil

“…This is in contrast with studies from other places in Brazil, which detected S. sonnei as the most frequent serogroups: Ribeirão Preto-SP (Medeiros et al 2001), and Salvador-BA (Diniz- Santos et al 2005). However, our finding is consistent with other reports from Northeastern Brazil (Lima et al 1995), Porto Alegre-RS (Santos et al 1997), and São José do Rio Preto-SP (Almeida et al 1998), and those from other Latin America developing countries such as Argentina (Merino et al 2004), Peru (Jones et al 2004), and Chile (Fulla et al 2005).…”

Epidemiology and Genetic Characterization of Noroviruses among Adults in an Endemic Setting, Peruvian Amazon Basin, 2004–2011

“…The range of organisms and co-infections noted in our study is similar to that previously reported in both children and adults in the region [ 24 , 33 ]. Interestingly, co-infection with Trichuris was associated with a decreased risk of diarrhea in persons also infected with NoV. Trichuris co-infection in children has been documented with numerous enteric organisms, including Entamoeba histolytica [ 34 ], Shigella spp.…”

Part II. Analysis of data gaps pertaining toShigellainfections in low and medium human development index countries, 1984–2005

“…Serotype 1a was the most frequently isolated in a population-based study in China [5]. Serotype 1b was the most frequently detected serotype in Malaysia and the Peruvian Amazon [44,45]. Subserotype 3c was reported from Malaysia and Pakistan, with reports of serotypes 7, 8, and High incidence (>100 episodes/1000 population) Medium incidence (>10-100 episodes/1000 population) Low incidence (р10 episodes/1000 population)…”